Endobronchial lipoma: CT diagnosis

Clinical and Radiological Manifestations of Primary Tracheobronchial Tumours: A Single Centre Experience

Introduction: Tracheobronchial tumours usually cause an airway obstruction and secondary pulmonary infections. Although rare, they are an important differential diagnosis as they may mimic other conditions and diseases. This paper aims to analyse clinical, radiological and histological characteristics of the patients with tracheobronchial tumours diagnosed for a period of 7 years. Materials and Methods: In this retrospective, observational study, we carefully reviewed 65 patients who were diagnosed with tracheal and endobronchial tumours, and performed statistical analysis on the results. Results: Among these 65 patients (36 men and 29 women) with a mean age of 48.8 years (range, 15 to 75), 50 had malignant tumours while 15 had benign ones. The most common symptoms were cough, chest pain and haemoptysis. Cough was a more frequent symptom in patients with benign tumours (P <0.0014). Only 2 patients were asymptomatic. Tumours were predominantly localised in the large airways (46 in large bronchi and 2 in trachea). The most common radiological manifestation of malignant tumours was tumour mass (46%) followed by atelectasis. One third benign tumour caused atelectasis, while tumour mass and consolidation were found in 3 patients each. Computerised tomography revealed endoluminal tumour mass in 29.2% of the cases, which was more frequently found in benign than malignant tumours (47% vs 24%, respectively). On bronchoscopy, tumours were visible in 73% and 70% benign and malignant cases respectively. Conclusion: Tracheobronchial tumours should be ruled as a possible diagnosis in patients with cough, haemoptysis, dyspnoea and chest pain. The imaging techniques and histological examination of the tissue would subsequently lead to correct diagnosis and proper treatment can be administered. Key words: Bronchus, Computerised tomography, Trachea, Tumour, X-ray

Imaging of tumors of the trachea and central bronchi

Tumors of the trachea and central bronchi can be benign or malignant. Clinical presentation may be confusing, particularly in benign tumors that can be misdiagnosed as asthma or chronic bronchitis. Chest radiography has many limitations and is often considered unremarkable in patients with tumors of the central airways; therefore, multidetector CT (MDCT) has become the most useful noninvasive method for diagnosing and assessing the central airways. The purpose of this article is to provide a review of imaging of the tumors of the trachea and central bronchi. We emphasize the crucial role of MDCT and postprocessing techniques in assessing neoplasms of the central airways.

Imaging of tumors of the trachea and central bronchi

Tumors of the trachea and central bronchi can be benign or malignant. Clinical presentation may be confusing, particularly in benign tumors that can be misdiagnosed as asthma or chronic bronchitis. Chest radiography has many limitations and is often considered unremarkable in patients with tumors of the central airways; therefore, multidetector CT (MDCT) has become the most useful noninvasive method for diagnosing and assessing the central airways. The purpose of this article is to provide a review of imaging of the tumors of the trachea and central bronchi. We emphasize the crucial role of MDCT and postprocessing techniques in assessing neoplasms of the central airways.

Lipoma endobrônquico

Os lipomas são neoplasias benignas compostas basicamente de tecido adiposo e podem se localizar em várias partes do corpo. O caso relatado é de uma paciente que procurou o serviço médico com queixa de pneumonias de repetição. Após a propedêutica diagnóstica, que incluiu radiografia simples de tórax e tomografia computadorizada de tórax, suspeitou-se que havia uma lesão endobrônquica com densidade de gordura. A hipótese diagnóstica era a presença de um lipoma endobrônquico como responsável pelo quadro clínico da paciente, que foi confirmada após tratamento cirúrgico. Os objetivos deste trabalho são relatar o caso de um lipoma endobrônquico e fazer uma revisão da literatura.

[Pleural empyema associated with endobronchial lipoma]

Bronchial benign tumors comprise fewer than 4% of pulmonary neoplasms. Endobronchial lipoma is an extremely rare benign neoplasm accounting for only 0.1% to 0.5% of all lung tumors. Clinical symptoms of lipoma depend on the location of the tumor, the severity of bronchial obstruction, and the functional and anatomical effects on the parenchyma distal to the obstruction. Computed axial tomography usually reveals the adipose composition of the lipomatous tumor. We report the case of an 83-year-old man diagnosed with community-acquired pneumonia that led to complications: pleural empyema caused by Haemophilus influenzae infection and atelectasis of the right middle and lower lobes secondary to a lipomatous endobronchial obstruction. Removal of the bronchial lipoma was performed by laser resection.